Provider Demographics
NPI:1346342029
Name:WINKLER, JAMES L (PA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:L
Last Name:WINKLER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 OKA ST
Mailing Address - Street 2:
Mailing Address - City:KILAUEA
Mailing Address - State:HI
Mailing Address - Zip Code:96754-5308
Mailing Address - Country:US
Mailing Address - Phone:808-828-2885
Mailing Address - Fax:808-828-0119
Practice Address - Street 1:2460 OKA ST
Practice Address - Street 2:
Practice Address - City:KILAUEA
Practice Address - State:HI
Practice Address - Zip Code:96754-5308
Practice Address - Country:US
Practice Address - Phone:808-828-2885
Practice Address - Fax:808-828-0119
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAMD-67363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIS64125Medicare UPIN
HI51321Medicare ID - Type Unspecified